Beneath It All (Beneath #1) (7 page)

Dr. Lauren examined my breasts, the whole grab, cup, poke, and feel routine that I had become accustomed to. He closed my gown, took off his gloves and was about to say something when Noah spoke up. “What would you recommend? In your professional opinion, what are the pros and cons?”

“Professionally, I’ll say that this is a very personal decision. Every woman is different, and frankly, the decision is Victoria’s. With the preliminary reports from the mammogram, ultrasound, and biopsy, your insurance would cover either option. One thing to keep in mind if you choose to do a lumpectomy: there is a very strong chance that you will have to do radiation. If you go with a mastectomy, due to the estimated size of your tumor, you most likely would avoid it.”

He took his glasses off and leaned back against the counter by the sink. “Personally, if it were my wife, I would trust her instincts and support her decision. She has to live with it for the rest of her life.”

“I’m having a bilateral mastectomy with reconstruction,” I stated to both of them and was met with a moment of silence as two sets of eyes searched my face for confirmation of my verbal decision.

Dr. Lauren was the first to speak up. “I’m not surprised by your decision, Victoria. You’re young and the fear of it coming back is more common in younger patients. There is nothing wrong with being proactive, and since you don’t have any medical history, I think you’re making the right decision for you.”

I looked over to Noah with imploring eyes, waiting for his response.

He finally spoke up. “Thank you for your honesty, Dr. Lauren, I appreciate it. After hearing what you had to say regarding the results from Dr. Frank and watching the myriad of expressions cross my wife’s face, I agree that she’s making the right decision.”

Noah stood up to walk toward me and placed his hand on top of mine, which were folded in my lap. “How soon can we get this scheduled?”

“I would like to get surgery scheduled as soon as possible. I see here you’re scheduled to see Dr. Blake Forrester this afternoon to discuss your reconstruction, is that correct?” I nodded my head in agreement.

“Good. I think you’ll like him. Once you come to an agreement on reconstruction, his office will contact mine to schedule surgery. There’s no need for you to schedule another appointment with me. Have you made an appointment with an oncologist yet?”

“Umm, no, not yet. I guess I didn’t even think about that,” I confessed, feeling like an idiot. “I guess I need to find one.”

“No worries. I’ve a few recommendations I can give you. I’ll get their cards while you’re getting dressed and will meet you in the hallway.” He reached over to shake my hand and then Noah’s before he left the room.

I dressed in silence and could feel Noah watching me. I could see the anguish on his face in his reflection in the mirror on the wall. He was starting to digest what was happening . . . really and truly happening.

When I was fully dressed, I turned toward him and our eyes met. I saw fear in his eyes, something I had never seen there before.

“Noah, it’s going to be okay. We have to know that. I’ve chosen the most radical surgery so that it’s all removed. I’m choosing to fight.” I tried my best to sound confident in my words and gave him my best reassuring smile before I turned toward the door. I’m sure it wasn’t very convincing, but I tried.

“Stop.”

I turned back around. He placed his hands on either side of my face with his forehead against mine. “You’re amazing. Simply amazing. I’m in awe of your strength because right now I’m so afraid, and I don’t know how you’re doing this.” He leaned down and gave me a chaste kiss before placing his hand in mine to exit the room together.

Dr. Lauren was waiting for us in the hallway like he had said. “Here are two oncologists in the area that I would recommend. I suggest you call today and make an appointment for early next week with each of them. It’s important to bring a list of the same questions to both doctors, as you want to be comfortable with your choice of doctor for treatment. You will be seeing him or her frequently.”

“Thank you again. We both appreciate your honesty and will be in touch.” I smiled, trying to keep my “I’m kicking ass and taking names” attitude going. “I guess I’ll see you again on the day of surgery.”

“Yes, you will. Take care of yourself, and please call if you have any more questions.”

“We will. Thank you, Dr. Lauren,” Noah added as he accompanied me toward the lobby.

Our hands didn’t part as we left the building. It was like we were two warriors going into battle . . . only this battle was raging in my body.

*

“Victoria Madison?”

I cringed.
How do they do that?
It’s just another normal, happy day for them, but all I wanted to do was curl up in the corner and cry.

I stood, and Noah grabbed my hand as we were escorted into another exam room with a table, two chairs, and a desk in the corner with a round spinning chair. As a kid I used to spin on them, but I’m sure if I tried today, I would end up nauseated. It was a nice thought though.

“Are you nervous?” Noah asked me as he sat in one of the chairs.

“No, I don’t think so.”
Who am I kidding?!
“Honestly, I really don’t know. I feel like I’m on a thrill ride at a theme park and I’ve no control over what happens next. I just have to trust that the ride isn’t going to get stuck at the top, or worse—derail.” I fought back the tears that were again threatening to spill out from my eyes.

I never thought I’d have a plastic surgeon. I’m not a vain person, and I planned to age gracefully. Yet, here I was, sitting in his office and suddenly feeling very awkward.

“It’s okay, Victoria. Everything will be okay,” Noah reassured me. “We are just talking with him to weigh our options. Nothing is set in stone, and if you don’t want to do reconstruction, it’s okay. I’ll support your choices.”

That did it. A few tears started gliding down my cheek just as there was a tap on the door. I quickly swiped them away and looked up as a gorgeous man walked into the room. My heart fluttered.

He was tall and lean, with thick dark hair that was every hairstylist’s dream. His eyes were a warm chocolate brown, and his skin was perfectly tanned. His suit was custom tailored, his tie was a striking cobalt blue, and his shoes . . . well . . . nice shoes were my weakness.
Gulp.

He approached me with his hand outstretched to take mine. “Good afternoon, Victoria. I’m Dr. Blake Forrester.” His firm but gentle grip caught me off guard, causing me to gasp quietly; he smiled before releasing my hand to turn toward Noah. “You must be Mr. Madison?”

“Yes, I am. Please, call me Noah.” Noah shook his hand with confidence. It felt awkward, like a testosterone surge was present in the room, even though it wasn’t.

Dr. Forrester sat down on the spinning chair and flipped opened my chart. He studied it for a few moments before turning back to look at me. “I received your report from Dr. Lauren’s office about fifteen minutes ago and understand that you would like to move forward with a bilateral mastectomy followed by reconstruction. Is that correct?”

“Yes, that’s correct. I’m not really sure what it all entails, but I know that I don’t want to wake up every day wondering if today will be the day I find a lump in my other breast.” The expression on his face told me that he understood my reasoning and he agreed.

“Dr. Lauren explained the mastectomy portion of the surgery to you. Did he get into the reconstruction portion of the surgery at all?”

I hesitated.
Did he?
I didn’t remember. “Honestly, I’m not sure.”
How was I supposed to remember everything?

Thankfully, Noah spoke up. “He briefly mentioned that it would be started immediately after the mastectomy, but didn’t elaborate much past that. I think he assumed you would explain that portion, since it’s your specialty.”

“Very well, when the mastectomy is completed, I’ll scrub in and start the reconstruction process by placing tissue expanders under your pectoral muscles. This part of the surgery goes fairly quickly. I’ll also place at least one drain on each side to alleviate the fluid build-up from the trauma.”

I looked a bit perplexed, and he picked up on it right away.

“With the removal of all of your breast tissue, we will need to place the implants under your muscle to hold them in place. In order to do this comfortably, we will need to stretch the muscle out gradually to make room for the permanent implant. The mastectomy along with reconstruction causes a lot of trauma to the area, and the body naturally produces fluid to protect itself. This will cause discomfort and can lead to complications or infection, so we place a tube, just under your skin, that is attached to a bulb that will extract the fluid from your body.”

A shivered passed through my body. “That’s just gross.”

That earned me full smile from Dr. Forrester, which made my heart skip a beat. He was too good looking for his own good. The man was charming and smart, and there was something about him that made me feel comfortable, but I couldn’t put my finger on it.

“Yes, the drains are a nuisance, but they are necessary. They’re generally in for one to two weeks and will be removed in the office once the fluid levels have decreased. It’s a very easy procedure,” he assured me.

“Understood,” I replied with a note of acknowledgment and disbelief. “Now, what exactly is an expander? This is all new to me.”

He reached into a drawer a pulled out what appeared to be an industrial water balloon with a metal disk on the bottom. “This is a tissue expander.” He held it flat in the palm of his hand. “It will be placed under your pectoral muscle with two hundred cc’s of saline in it to start the expanding process. Once you have healed, we’ll start filling the expander with saline until we get it to the size we want.”

What? Wait a minute. Fill the expander? How the hell was he going to do that?
The look of sheer horror was more than evident on my face.

“By the look on your face, I’m sure you are wondering how it will be filled,” Dr. Forrester said, a hint of humor in his voice.

There was nothing funny about this. It sounded more like some sixteenth-century form of torture.

“Well, yes, please enlighten me, because I have a feeling that long needles are involved, and that just isn’t going to fly with me!”

“You’re correct; it does involve a needle.” He smiled as he held up the expander and pointed to a metal disk at the top of it. “This is a port. We locate it with a magnet so that we know where to insert a needle that will fill the expander with saline and not damage the expander. The actual fill process takes about fifteen to twenty minutes in the office and can be done every week or every other week, depending on your comfort level,” he explained. “You call the shots on when you want it done and how much saline you want injected. Your comfort is what’s most important.”

I sat there for a moment, not knowing what to say. Noah looked at me and could see I was struggling, so he jumped in: “Dr. Forrester, how long does the entire fill process typically take? Are will talking three to six months, or longer?”

“Generally, women can comfortably handle between twenty-five and fifty cc’s at each fill. A few have had up to one hundred cc’s, but that’s rare. The tolerable amount is determined during the procedure by the patient. If they say ‘stop,’ we stop, and each session is different. One week you might be able to take more and the next time it might be less. However, my limit’s one hundred cc’s at a time. In calculating everything, it will take approximately two to four months from the first fill to get to where we are able to place the permanent implant.”

“Am I awake for the fills?”
Please say no, please say no, pretty pretty please say no!

“Yes, you’re awake, but you don’t need to watch. You’ll feel some pressure and mild discomfort, but it’s a fairly simple procedure. Have you thought about if you want saline or silicone implants?”

Smooth change of subject, I thought, and replied, “Not really, but I think I want saline. I’ve heard that there isn’t a problem if they leak and they’re safer. All the horror stories of silicone over the years makes me hesitant.”

“That’s fair. We don’t have to make the decision right now, but in my professional opinion, I would suggest that you consider silicone. Generally, most mastectomy patients find the silicone implants are more comfortable and less rigid.”

Reaching into another drawer, he pulled out two more heavy-duty water balloons. These were full, and he handed one to me and one to Noah. He was like a magician with a magic hat, only he was pulling out fake boobs instead of rabbits.

I was holding one that appeared to be filled with gel, and he explained. “Silicone implants are now manufactured with mesh inside the capsule, and the silicone adheres to it, so if there’s a rupture, the silicone stays attached to the mesh and doesn’t leak out. I’ve been using them since they were reintroduced to the market, and I’ve been very pleased with their performance.”

Noah looked at it with curiosity and couldn’t help the smirk on his face.
Yep. Men and fake boobs. Need I say more?